We know in psychotic person, activity of Dopamine and 5HT is increased.
A) Typical antipsychotic drugs
These are mainly dopamine activity suppressors and have some action on 5HT activity also.Various groups comes under typical antipsychotics like,
1) Phenothiazines-
Chlorpromazine– It is the prototype drug of this group and have various other uses also.
Uses :-
•In high doses treats psychosis , at low doses acts as anti emetic.••Used to stop hiccups
•Treats positive symptoms of psychosis.••It may be used as lactogogue
A/E :- When we give Chlorpromaxine it decreases dopamine at conginitive area and treats psychosis but it also decreases dopamine on other sites which may cause some unwanted effects like,
•When it decreases dopamine at pituitary then prolactin level increases which may cause Galactorrhea.We know normally dopamine keeps check on the level of prolactin but when dopamine levels are decreased then automatically prolactin increases which may lead to galactorrhea.
•When it decreases dopamine levels at basal ganglia then it may lead to involuntary movements like akathesia, chorea, tardic dyskinesia, Athetosis, Tremors etc.
•Due to its action on hypothalamus it may cause autonomic dysfunction like, postural hypotension, tachycardia, hyperthermia, constipation, xerostomia etc.
•Sedation
Promazine
Theoridazine– It have less adverse effects but have risk of retinopathy
Fluphenazine
Prochlorperazine– It also have anti vertigo + anti emetic action
Triflupromazine
2) Butyrophenones
They are more potent than phenothiazines which means they are used in less dose as compared to phenothiazines.
Haloperidol
Trifluperidol
Penfluridol
3) Thioxanthines
Flupenthixol– More effective against apathetic psychosis.
Clopenthixol
4) Heterocyclics
Used in apathetic psychosis.
Pimozide
Loxapine
B) Atypical antipsychotic drugs
They have a great action on decreasing the activity of 5HT and have some action on 5HT levels. Atypical antipsychotics are used in psychosis and also in special Anxiety disorders like delusion of parasitosis,OCD etc.
A/E:-
•Hyperphagia so, it may cause weight gain in patient
•May cause hyperglycemia do their is a risk of DM
•May cause Dyslipidemia
•May cause HTN
It includes drugs like-
–Clozapine– It is one of the most effective anti Psychotic so it is used only in resistant cases of schizophrenia especially with suicidal tendency.
Main side effects of this drug-
•Agranulocytosis
•Wet pillow syndrome or hypersalivation
•May cause cardiac arrythmia, hypotension
•Can cause seizures even in non epileptic patients.
All these drugs are similar to Clozapine but have less adverse effects than Clozapine.
-Quetiapine
–Respirdon
–Ziprasidon
-Aripiprazol
Contributor- Medico Anant Singh Nanda